No hepatologist in the United States, even at major medical centers, sees a sufficient number of patients to carry out controlled trials of 1) controversial therapies, or 2) new methods of treating acute hepatic insufficiency. Investigators of the Acute Hepatic Failure Study Group have combined their efforts for cooperative evaluations of methods of therapy. The Group is now assessing the role of corticosteroids in acute hepatic failure at 16 centers to determine whether this adjunct has any influence upon survival. Various forms of glucocorticoid have been used on a world-wide basis since 1952, but no adequately controlled study has ever been done. Results have suggested both lack of benefit and actual harm. Participating investigators estimate they can randomize a sufficient number of cases in a three-year period to determine whether corticosteroids have any influence on outcome, either early (based on survival) or long-term (based on occurrence of chronic liver disease). The study serves two additional purposes: 1) collecting data on non-randomized patients to define better the natural history of the disease, and, 2) collecting sera for a bank available to qualified investigators in evaluating new tests relating to prognostic factors and/or pathophysiologic concepts.